Knee Pain and Inability to Straighten: Lateral Ligament Injuries

Inability to fully extend the knee with lateral pain?

Hello Doctor, I injured my knee while playing basketball.
The specific symptoms are that I cannot fully extend my knee, and if I force it to extend, there is significant pain on the outer side of the knee.
I also feel discomfort on the outer side of the knee when squatting down completely, but there is no pain or swelling in the knee itself.
During my first visit to the doctor, he diagnosed it as a lateral ligament strain and said it would heal in a week.
After two weeks of rehabilitation and rest, I still tend to walk on my toes with the injured leg to avoid fully extending the knee, but overall, I have recovered to a normal walking speed.
However, the outer side of the knee still hurts when fully extended.
During my second visit, the doctor listened to my description with confusion and mentioned it could possibly be a lateral ligament injury or iliotibial band syndrome, advising me to rest and continue rehabilitation.
After researching online, I feel that my symptoms do not align with iliotibial band syndrome.
The persistent issues with my knee are concerning, and I am unable to play basketball or engage in normal activities.
I would like to ask you some questions, and I would greatly appreciate your answers.

1.
Are my symptoms indicative of a lateral ligament strain, or could there be other causes?
2.
How long is the expected recovery time? Does rehabilitation (heat therapy and electrical stimulation) really help with my symptoms?
3.
What protective measures or actions can I take in my daily life to expedite recovery?
4.
What do you recommend I do at this stage?

aba, 20~29 year old female. Ask Date: 2019/04/17

Dr. Wang Jiacheng reply Orthopedics

It is advisable to seek multiple opinions, such as consulting other orthopedic surgeons for treatment.
I hope this helps you.
Wishing you good health.

Reply Date: 2019/04/17

More Info

Knee injuries, especially those involving the lateral ligaments, can be quite complex and often require careful evaluation and management. Based on your description, it seems you are experiencing significant discomfort and functional limitations following a basketball injury. Let's address your questions one by one.

1. Is my symptom a lateral ligament strain, or could it be something else?
Your symptoms, particularly the inability to fully straighten your knee and the pain on the outer side when attempting to do so, suggest a possible lateral ligament injury, such as a sprain of the lateral collateral ligament (LCL). However, other conditions could also be at play, such as a meniscus tear or iliotibial band syndrome. The absence of swelling and redness is somewhat reassuring, but it does not rule out significant soft tissue injury. A thorough physical examination and possibly imaging studies like an MRI may be necessary to confirm the diagnosis and rule out other injuries.

2. How long will it take to recover? Does rehabilitation (heat therapy and electrical stimulation) really help?
Recovery time for a lateral ligament strain can vary widely depending on the severity of the injury. Mild strains may heal within a few weeks, while more severe injuries could take several months. Rehabilitation is crucial in this process. Modalities like heat therapy can help with pain relief and muscle relaxation, while electrical stimulation can promote muscle activation and reduce atrophy. Engaging in a structured rehabilitation program that includes strengthening and flexibility exercises will be beneficial for your recovery.

3. What can I do in my daily life to protect my knee and speed up recovery?
To facilitate healing, consider the following measures:
- Rest and Avoid Aggravating Activities: Limit activities that exacerbate your knee pain, particularly sports or movements that require sudden changes in direction.

- Ice Therapy: Applying ice to the affected area can help reduce pain and inflammation, especially after activity.

- Compression and Elevation: Using a knee brace or wrap can provide support and reduce swelling. Elevating your leg can also help decrease swelling.

- Gentle Stretching and Strengthening: Engage in gentle stretching and strengthening exercises as tolerated. Focus on the muscles around the knee, including the quadriceps and hamstrings, to provide better support.

- Gradual Return to Activity: Once your pain subsides, gradually reintroduce activities, starting with low-impact exercises before returning to basketball.

4. What should I do now?
Given that your symptoms have not significantly improved, it may be wise to seek a follow-up appointment with a healthcare provider, preferably one who specializes in sports medicine or orthopedics. They can perform a detailed assessment and possibly order imaging studies to better understand the extent of your injury. If a specific diagnosis is made, they can tailor a rehabilitation program to your needs. In the meantime, continue with rest, ice, and gentle rehabilitation exercises as tolerated.

In conclusion, while lateral ligament injuries can be concerning, many individuals recover well with appropriate management. It is essential to listen to your body and avoid pushing through pain, as this can lead to further injury. A collaborative approach with your healthcare provider will ensure you receive the best care possible, allowing you to return to your desired activities safely.

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